Application to vary a premises licence to specify an individual as designated premises supervisor from South Derbyshire District Council
Step 1 of 4 Complete the application form
First, download the form
Right-click the link below and select the 'Save' option
Next, fill in the application form on your computer
To edit the form you'll need a recent version of Adobe Reader.
Open the form using Adobe Reader instead of your web browser.
If you can't complete the form right now don't worry, you can edit it in your own time. Once you're ready, return to this page to complete the application.
There is additional information available for this licence that you might find useful:General information from the licensing authority More detailed information on legislation etc.
Before you apply...
There's a £23.00 fee.
You'll need a debit or credit card.
You'll need to provide copies of the following:
- Existing Premises Licence (optional)
- Consent form of DPS (optional)
What if I don't have electronic copies?
Photos or scans of documents are acceptable, providing the relevant information is clear.
If you can't provide electronic versions you can still apply online, but you'll need to send in copies by post. We'll give you the address and reference number once you've completed the application.
Now, submit the application